This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Study 1 will use [18-]-fluoro-deoxyglucose positron emission tomography (FDG-PET) to delineate the specific brain circuit mediation of Obsessive-Compulsive Disorder (OCD) and Major Depressive Disorder (MDD)occurring simultaneously, in patients treated with paroxetine, a medication shown to be effective for both disorders. Differential cerebral metabolic changes occurring along parallel, frontal-subcortical brain circuits will be measured after four weeks and again, after 12 weeks of treatment, and will be correlated with specific symptomatic changes. Understanding the mediation of OCD and MDD by specific neuroanatomical circuits, as well as the differential time course of pharmacological effects on these circuits, may lead to improved treatments for both of these common disorders in the future. Study 2 will a)examine the efficacy of adjunctive risperidone for OCD patients who are refractory to proxetine and, b) identify symptom, other clinical variables, and cerebral metabolic patterns that might predict response to adjunctive risperidone.
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